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Is poor observation still putting patients at risk?


Answer our survey to help us investigate this essential area of care.

In 2009 Nursing Times revealed that poor observation practice was putting patients’ lives at risk.

We found nurses around the country were concerned about the quality of observation on their wards, with many warning low staffing levels, insufficient training and increased use of technology were contributing to failures to identify deteriorating patients.

Has anything changed? What is the current state of patient observation on your ward? Nursing Times is reinvestigating this essential area of care.


Readers' comments (6)

  • I think that much is due to too much emphasis these days upon nurses having far too much paper work and also carrying out so much more of junior doctors work load, that basic nursing care sadly seems to be taking second place

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  • Evellyn that is only part of the problem.

    The biggest problem is that there simly are not enough staff to look after the amount of patients we have. It really is as simple as that.

    For example, I can look after a highly acute patient in a high dependancy unit (for example, any other area is similar for this context), perform complex clinical procedures, monitor their vitals and act accordingly, and document everything I need to. When that patient turns into 4, I become busy, but it is doable. When it becomes 6, things get a bit pushed. 10 patients, 15, 20, 30 even (and these high numbers are not uncommon) for a single staff Nurse, and things simply cannot be done.

    That is the real problem.

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  • We need to get back to basics- observations and/or early warning scores if correctly interpreted ensure that small changes however subtle in a patients condition are acted on. As Evelyn says this is about basic nursing care and unless we ensure that this has priority above everything else then patients will be put at risk. As nurses we have a professional responsibility first and foremost to our patients.

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  • Anonymous | 18-Jan-2011 3:52 pm it's not that I disagree, but we need decent staffing levels to be able to do that.

    Furthermore I think another problem is the trend of trusts hiring and using more HCA's to perform tasks like this. They may be trained to record the numbers, but there is no guarantee they know what those numbers mean or will recognise a deteriorating pattern when they see one. I have lost count of the times I have seen this happen.

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  • I agree with Mike - staff levels are too low and HCA numbers are increasing. My brother has unfortunately been recently diagnosed with cancer and attended a different hospital environment than the one I work in. He laughed about a HCA who was to take his temp and blood pressure and kept walking off to do different things, after two hours she eventually took it and then forgot to write it down on a chart. Some HCA's have received better training and have more experience but I can't say all of them are dependable when left to carry out tasks and report EWS back to nurses.

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  • i am an agency staff nurse. I recently worked on a ward where all the patients' observations were fed into a hand held device and fed into a central computer where they were interpreted, in a different part of the hospital, by a nurse practitioner. Very efficient, you might think, until I, as the nurse actually looking after the patients, wanted to know what their blood-pressures had been prior to handing out hypotensive medication, but I had no means of instantly finding this out. Bring back charts at the end of the beds!! Teach people to OBSERVE their patients. All these machines and scores etc are no replacement for real nursing and central computers are de-skilling the nurses on the wards. Look how discredited BMI scores have become by too much reliance on numbers and insufficient application of common sense!

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